World Academy of Science, Engineering and Technology

Authors: Mahdi Eskandarlou, Mehrdad Taghipour

Abstract:

Background: Partial-thickness skin graft is the cornerstone for scalp defect repair. Routine donor sites include abdomen, thighs, and buttocks. Given the potential side effects following harvesting from these sites and the potential advantages of harvesting from scalp (broad surface, rapid healing, and better cosmetics results), this study is trying to compare the outcomes of graft harvesting from scalp and lower limb. Methods: This clinical trial is conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to plastic surgery clinic at Besat Hospital during the time period between 2018 and 2019. Sampling was done by simple randomization using random digit table. Data gathering was performed using a designated checklist. The donor site in case group and control group was scalp and lower limb, respectively. The resultant data were analyzed using chi-squared and t-test and SPPS version 21 (SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). Results: Of the total 40 patients participating in this study, 28 patients (70%) were male, and 12 (30%) were female with and mean age of 63.62 ± 09.73 years. Hypertension and diabetes mellitus were the most common comorbidities among patients with basal cell carcinoma (BCC) and trauma being the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The most common anatomic location of defect for case and control groups was temporal and parietal, respectively. Most of the defects were deep to galea zone. The mean diameter of defect was 24.28 ± 45.37 mm for all of the patients. The difference between diameter of defect in both groups was statistically meaningful, while no such difference between graft diameter was seen. The graft 'Take' was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale, and the satisfaction was higher in them per Likert scale. Conclusion: Scalp can safely be used as donor site for skin graft to be used for scalp defects, which is associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, leg, partial-thickness graft, scalp

Procedia PDF Downloads 134

Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

Abstract:

Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: robotics and automation, engineering management, engineering in medicine and biology, medical services, public health-care

Procedia PDF Downloads 136

Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan

Abstract:

We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

Keywords: daily activity recognition, healthcare, IoT sensors, transfer learning

Procedia PDF Downloads 120

Authors: William Whiteley, Jens Gregor

Abstract:

In recent developments of direct neural network based positron emission tomography (PET) reconstruction, two prominent architectures have emerged for converting measurement data into images: 1) networks that contain fully-connected layers; and 2) networks that primarily use a convolutional encoder-decoder architecture. In this paper, we present a multi-modal direct PET reconstruction method called MDPET, which is a hybrid approach that combines the advantages of both types of networks. MDPET processes raw data in the form of sinograms and histo-images in concert with attenuation maps to produce high quality multi-slice PET images (e.g., 8x440x440). MDPET is trained on a large whole-body patient data set and evaluated both quantitatively and qualitatively against target images reconstructed with the standard PET reconstruction benchmark of iterative ordered subsets expectation maximization. The results show that MDPET outperforms the best previously published direct neural network methods in measures of bias, signal-to-noise ratio, mean absolute error, and structural similarity.

Keywords: deep learning, image reconstruction, machine learning, neural network, positron emission tomography

Procedia PDF Downloads 94

Authors: Susanne Gustafsson

Abstract:

Life-history research is an extraordinarily fruitful method to use for social analysis and gendered health analysis in particular. Its potential is illustrated through a case study drawn from a Swedish project. It reveals an old type of masculinity that faces difficulties when carrying out two sets of demands simultaneously, as a worker/manager and as a father/husband. The paper illuminates the historical transformation of masculinity and the consequences of this for health. We draw on the idea of the “changing faces of masculinity” to explore the dynamism and complexity of gendered health. An empirical case is used for its illustrative abilities. Jan, a middle-level manager and father employed in the energy sector in urban Sweden is the subject of this paper. Jan’s story is one of 32 semi-structured interviews included in an extended study focusing on well-being at work. The results reveal a face of masculinity conceived of in middle-level management as tacitly linked to the neoliberal doctrine. Over a couple of decades, the idea of “flexibility” was turned into a valuable characteristic that everyone was supposed to strive for. This resulted in increased workloads. Quite a few employees, and managers, in particular, find themselves working both day and night. This may explain why not having enough time to spend with children and family members is a recurring theme in the data. Can this way of doing be linked to masculinity and health? The first author’s research has revealed that the use of gender in health science is not sufficiently or critically questioned. This lack of critical questioning is a serious problem, especially since ways of doing gender affect health. We suggest that gender reproduction and gender transformation are interconnected, regardless of how they affect health. They are recognized as two sides of the same phenomenon, and minor movements in one direction or the other become crucial for understanding its relation to health. More or less, at the same time, as Jan’s masculinity was reproduced in response to workplace practices, Jan’s family position was transformed—not totally but by a degree or two, and these degrees became significant for the family’s health and well-being. By moving back and forth between varied events in Jan’s biographical history and his sociohistorical life span, it becomes possible to show that in a time of gender transformations, power relations can be renegotiated, leading to consequences for health.

Keywords: changing faces of masculinity, gendered health, life-history research method, subverter

Procedia PDF Downloads 99

Authors: S. Gustafsson

Abstract:

The aim of this paper is to explore the connection between gender, agency, and health on personal and social levels over time. The use of gender as an analytical tool for health research has been shown to be useful to explore thoughts and ideas that are taken for granted, which have relevance for health. The paper highlights the following three issues. There are multiple forms of femininity and masculinity. Agency and social structure are closely related and referred to in this paper as 'gender agency'. Gender is illuminated as a product of history but also treated as a social factor and a producer of history. As a prominent social factor in the process of shaping living conditions, gender is highlighted as being significant for understanding health. To make health explicit as a dynamic and complex concept and not merely the opposite of disease requires a broader alliance with feminist theory and a post-Bourdieusian framework. A personal story, included with other ethnographic material about women’s networking in rural Sweden, is used as an empirical illustration. Ethnographic material was chosen for its ability to illustrate historical, local, and cultural ways of doing gendered and capitalized health. New concepts characterize ethnography, exemplified in this study by 'processes of transformation'. The semi-structured interviews followed an interview guide drafted with reference to the background theory of gender. The interviews lasted about an hour and were recorded and transcribed verbatim. The transcribed interviews and the author’s field notes formed the basis for the writing up of this paper. Initially, the participants' interests in weaving, sewing, and various handicrafts became obvious foci for networking activities and seemed at first to shape compliance with patriarchy, which generally does the opposite of promoting health. However, a significant event disrupted the stability of this phenomenon. What was permissible for the women began to crack and new spaces opened up. By exploiting these new spaces, the participants found opportunities to try out alternatives to emphasized femininity. Over time, they began combining feminized activities with degrees of masculinity, as leadership became part of the activities. In response to this, masculine enactment was gradually transformed and became increasingly gender neutral. As the tasks became more gender neutral the activities assumed a more formal character and the women stretched the limits of their capacity by enacting gender agency, a process the participants referred to as 'personal growth' and described as health promotion. What was described in terms of 'personal growth' can be interpreted as the effects of a raised status. Participation in women’s networking strengthened the participants’ structural position. More specifically, it was the gender-neutral position that was rewarded. To clarify the connection between gender, agency, and health on personal and social levels over time the concept processes of transformation is used. This concept is suggested as a dynamic equivalent to habitus. Health is thus seen as resulting from situational access to social recognition, prestige, capital assets and not least, meanings of gender.

Keywords: a cross-gender bodily hexis, gender agency, gender as analytical tool, processes of transformation

Procedia PDF Downloads 141

Authors: Dalvin D. Hill, Hector M. Castro Garcia

Abstract:

A growing number of individuals utilize wearable devices on a daily basis. The usage and functionality of these wearable devices vary from user to user. One popular usage of said devices is to track health-related activities that are typically stored on a device’s memory or uploaded to an account in the cloud; based on the current trend, the data accumulated from the wearable device are stored in a standalone location. In many of these cases, this health related datum is not a factor when considering the holistic view of a user’s health lifestyle or record. This health-related data generated from wearable and Internet of Things (IoT) devices can serve as empirical information to a medical provider, as the standalone data can add value to the holistic health record of a patient. This paper proposes a solution to incorporate the data gathered from these wearable and IoT devices, with that a patient’s Personal Health Record (PHR) stored within the confines of a Health Information Exchange (HIE).

Keywords: electronic health record, health information exchanges, internet of things, personal health records, wearable devices, wearables

Procedia PDF Downloads 112

Authors: Maariyah Irfan

Abstract:

Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

Procedia PDF Downloads 122

Authors: Idowu R. Akomolafe, Naven Chetty

Abstract:

Background: The widespread medical application of ionizing radiation has raised public concern about radiation exposure and, thus, associated cancer risk. The production of reactive oxygen species and free radicals as a result of radiation exposure can cause severe damage to deoxyribonucleic acid (DNA) of cells, thus leading to biological effect. Radiotherapy is an excellent modality in the treatment of cancerous cells, comes with a few challenges. A significant challenge is the exposure of healthy cells surrounding the tumour to radiation. The last few decades have witnessed lots of attention shifted to plants, herbs, and natural product as an alternative to synthetic compound for radioprotection. Thus, the study investigated the radioprotective efficacy of Costus afer against whole-body radiation-induced haematological, histopathological disorder in mice. Materials and Method: Fifty-four mice were randomly divided into nine groups. Animals were pretreated with the extract of Costus afer by oral gavage for six days before irradiation. Control: 6 mice received feed and water only; 6 mice received feed, water, and 3Gy; 6 mice received feed, water, and 6Gy; experimental: 6 mice received 250 mg/kg extract; 6 mice received 500 mg/kg extract; 6 mice received 250 mg/kg extract and 3Gy; 6 mice received 500 mg/kg extract and 3Gy; 6 mice received 250 mg/kg extract and 6Gy; 6 mice received 500 mg/kg extract and 6Gy in addition to feeding and water. The irradiation was done at the Radiotherapy and Oncology Department of Grey's Hospital using linear accelerator (LINAC). Thirty-six mice were sacrificed by cervical dislocation 48 hours after irradiation, and blood was collected for haematology tests. Also, the liver and kidney of the sacrificed mice were surgically removed for histopathology tests. The remaining eighteen (18) mice were used for mortality and survival studies. Data were analysed by one-way ANOVA, followed by Tukey's multiple comparison test. Results: Prior administration of Costus afer extract decreased the symptoms of radiation sickness and caused a significant delay in the mortality as demonstrated in the experimental mice. The first mortality was recorded on day-5 post irradiation, and this happened to the group E- that is, mice that received 6Gy but no extract. There was significant protection in the experimental mice, as demonstrated in the blood counts against hematopoietic and gastrointestinal damage when compared with the control. The protection was seen in the increase in blood counts of experimental animals and the number of survivor. The protection offered by Costus afer may be due to its ability to scavenge free radicals and restore gastrointestinal and bone marrow damage produced by radiation. Conclusions: The study has demonstrated that exposure of mice to radiation could cause modifications in the haematological and histopathological parameters of irradiated mice. However, the changes were relieved by the methanol extract of Costus afer, probably through its free radical scavenging and antioxidant properties.

Keywords: costus afer, hematological, mortality, radioprotection, radiotherapy

Procedia PDF Downloads 125

Authors: Nazma Sultana

Abstract:

Social media has become an important part of our daily life. It has a significance influences on the people who use them in their daily life frequently. The number of people using social network sites has been increasing continuously. For this frequent utilization has started to affect our social life. This study examine whether the use of social network sites affects the psychosocial interaction between children and their parents. At first parents introduce their children to the internet and different type of device in their early childhood. Many parents use device for feeding their children by watching rhyme or cartoon. As a result children are habituate with it. In Bangladesh 70% people are heavy internet users. About 23 percent of them spend more than five hours on the social networking sites a day. Media are increasing pervasive in the lives of children-roughly the average child today spends nearly about 45 hours per week with media, compared with 17 hours with parents and 30 hours in school. According to a social learning theory, children & adolescents learn by observing & imitating what they see on screen particularly when these behaviors are realistic or are rewarded. The influence of the media on the psychosocial development of children is profound. Thus it is important for parents to provide guidance on age-appropriate use of all media, including television, radio, music, video games and the internet.

Keywords: social media, psychosocial, Technology, Parent, Social Relationship, Adolescents, Teenage, Youth

Procedia PDF Downloads 95

Authors: Pavel Porubiak, Lukas Kudlacek

Abstract:

Introduction Transplant tourism is a controversial method of obtaining an organ, and that goes all the more for a country such as China, where sources of evidence point out to the possibility of organs being harvested illegally. This research aimed at listing the individual countries these tourists come from, or which medical companies sell transplant related products in there, with China being used as an example. Materials and methods The methodology of scoping study was used for both parts of the research. The countries from which transplant tourists come to China were identified by a search through existing medical studies in the NCBI PubMed database, listed under the keyword ‘transplantation in China’. The search was not limited by any other criteria, but only the studies available for free – directly on PubMed or a linked source – were used. Other research studies on this topic were considered as well. The companies were identified through multiple methods. The first was an online search focused on medical companies and their products. The Bloomberg Service, used by stock brokers worldwide, was then used to identify the revenue of these companies in individual countries – if data were available – as well as their business presence in China. A search through the U.S. Securities and Exchange Commission was done in the same way. Also a search on the Chinese internet was done, and to obtain more results, a second online search was done as well. The results and discussion The extensive search has identified 14 countries with transplant tourists to China. The search for a similar studies or reports resulted in finding additional six countries. The companies identified by our research also amounted to 20. Eight of them are sourcing China with organ preservation products – of which one is just trying to enter the Chinese market, six with immunosuppressive drugs, four with transplant diagnostics, one with medical robots which Chinese doctors use for transplantation as well, and another one trying to enter the Chinese market with a consumable-type product also related to transplantation. The conclusion The question of the ethicality of transplant tourism may be very pressing, since as the research shows, just the sheer amount of participating countries, sourcing transplant tourists to another one, amounts to 20. The identified companies are facing risks due to the nature of transplantation business in China, as officially executed prisoners are used as sources, and widely cited pieces of evidence point out to illegal organ harvesting. Similar risks and ethical questions are also relevant to the countries sourcing the transplant tourists to China.

Keywords: China, illegal organ harvesting, transplant tourism, organ harvesting technology

Procedia PDF Downloads 118

Authors: Sengul Celik, Alper Ketenci

Abstract:

In Turkish Constitution about health care in Article 56, it is said that: everyone has the right to live in a healthy and balanced environment. It is the duty of the state and citizens to improve the environment, protect environmental health, and prevent environmental pollution. The state ensures that everyone lives their lives in physical and mental health; it organizes the planning and service of health institutions from a single source in order to realize cooperation by increasing savings and efficiency in human and substance power. The state fulfills this task by utilizing and supervising health and social institutions in the public and private sectors. General health insurance can be established by law for the widespread delivery of health services. To have health care is one of the basic rights of patients. After the coupe attempt in July 2016, the Government of Turkey has announced a state of emergency and issued lots of emergency decrees. By these emergency decrees, lots of people were dismissed from their jobs and lost their some basic social rights. The violations occur in social life. One of the most common observations is the discrimination by government in health care system. This study aims to put forward the violation of human rights in health care system in Turkey due to their discriminated position by an emergency decree. The study is a case study that is based on nine interviews with the people or relatives of people who lost their jobs by an emergency decree in Turkey. In this study, no personally identifiable information was obtained for the safety of individuals. Also no distinctive questions regarding the identity of individuals were asked. The interviews are obtained through internet call applications. The data were analyzed through the requirements of regular health care system in Turkey. The interviews expose that the people or the relatives of people lost their right to have regular health care. They have to pay extra amount both in clinical services and in medication treatment. The patient right to quality medical care without prejudice is violated. It was assessed that the people who are involved in emergency decree and their relatives are discriminated by government and deprived of regular medical care and supervision. Although international legal arrangements and legal responsibilities of the state have been put forward by Article 56, they are violated in practice. To prevent these kinds of violations, some measures should be taken against the deprivation in health care system especially towards the discriminated people by an emergency decree.

Keywords: emergency decree in Turkey, health care, discriminated people, patients rights

Procedia PDF Downloads 94

Authors: Noura Al-Ajmi, Mohammed A. Almulla

Abstract:

With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.

Keywords: headache diagnosis system, prescription recommender system, expert system, backward rule-based system

Procedia PDF Downloads 188

Authors: U. Gunal, H. I. Turgut, H. Gurler, S. Kaya

Abstract:

There are many ever-increasing and newly emerging problems with rapid population growth in the world. With the increase in people's quality of life in our daily life, acoustic comfort has become an important feature in the textile industry. In order to meet all these expectations in people's comfort areas and survive in challenging competitive conditions in the market without compromising the customer product quality expectations of textile manufacturers, it has become a necessity to bring functionality to the products. It is inevitable to research and develop materials and processes that will bring these functionalities to textile products. The noise we encounter almost everywhere in our daily life, in the street, at home and work, is one of the problems which textile industry is working on. It brings with it many health problems, both mentally and physically. Therefore, noise control studies become more of an issue. Besides, materials used in noise control are not sufficient to reduce the effect of the noise level. The fabrics used in acoustic studies in the textile industry do not show sufficient performance according to their weight and high cost. Thus, acoustic textile products can not be used in daily life. In the thesis study, the attributions used in the noise control and building acoustics studies in the literature were analyzed, and the product with the highest damping value that a textile material will have was designed, manufactured, and tested. Optimum values were obtained by using different material samples that may affect the performance of the acoustic material. Acoustic measurement methods should be applied to verify the acoustic performances shown by the parameters and the designed three-dimensional structure at different values. In the measurements made in the study, the device designed for determining the acoustic performance of the material for both the impedance tube according to the relevant standards and the different noise types in the study was used. In addition, sound records of noise types encountered in daily life are taken and applied to the acoustic absorbent fabric with the aid of the device, and the feasibility of the results and the commercial ability of the product are examined. MATLAB numerical computing programming language and libraries were used in the frequency and sound power analyses made in the study.

Keywords: acoustic, egg crate, fabric, textile

Procedia PDF Downloads 92

Authors: Dalia Rimawi, Walid Salameh, Amal Al-Omari, Hadeel AbdelKhaleq

Abstract:

Predication of Survival time of patients with cancer, is a core factor that influences oncologist decisions in different aspects; such as offered treatment plans, patients’ quality of life and medications development. For a long time proportional hazards Cox regression (ph. Cox) was and still the most well-known statistical method to predict survival outcome. But due to the revolution of data sciences; new predication models were employed and proved to be more flexible and provided higher accuracy in that type of studies. Artificial neural network is one of those models that is suitable to handle time to event predication. In this study we aim to compare ph Cox regression with artificial neural network method according to data handling and Accuracy of each model.

Keywords: Cox regression, neural networks, survival, cancer.

Procedia PDF Downloads 178

Authors: Mwamba Mwamini Ruth

Abstract:

For many authors,the percentage of married or in union persons using family planning methods has increased significantly since the 1960s, despite this progress, important differences across régions are observer.These différences become even greater,to present a paradox,when studying the issue in smallest territorial entities in developing countries.In line with the above,the general objective of this research is to investigate into "knowledge , attitude and practice"of households from a basic territorial entity,here in"Murara Sector"(in the city of Goma, province of North Kivu,Democratic Republic of Congo,Africa)on family planning (as defined and provisioned by the four World Health Organization-WHO key texts on the matter)

Keywords: DRC, family planning methods, information technology, Murara

Procedia PDF Downloads 118

Authors: Hilal Al Shamsi, Abdullah Almutairi

Abstract:

Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

Procedia PDF Downloads 176

Authors: Preeti Tiwari, Jay Wood, Duncan Babbage

Abstract:

Family planning plays a role in saving lives across the globe by preventing unwanted pregnancies. The purpose of this multidisciplinary research was to determine the impact of mHealth tools have on psychosocial determinants of behaviour for family planning. The present study examines a topic that is very relevant in times where human-technology interaction is at its peak. It is probably one of the first studies that have investigated the impact of mobile phone technology on the underlying mechanisms of behaviour change for family planning using primary data. To examine the association between exposure to mHealth tools and predictors of behaviour, data was collected from mHealth intervention areas in India. A post-intervention quasi-experimental study with a 2x2 factorial design was conducted among 831 men and women from the state of Bihar. The quantitative data analysis evaluated the extent of influence that predictors of behaviour (beliefs, social norms, perceived behaviour control, and outcome behaviour) have on a woman’s decisions about family planning. The results indicated an association between exposure to mHealth tools and improved communication about family planning among various family members after receiving health information from a health worker (H1). A relationship between exposure to mHealth tools and increased support women received from their husbands and extended family (mothers-in-law specifically) and peers (H2) was also found. A further result showed that knowledge about family planning was greater among users of family planning (H4). mHealth tools empower women to communicate with family members. This has important implications for developing mobile phone-based tools, as they can be used as a crucial communication channel that can be an effective method of increasing communication among family members about contraceptives. Thus, it can be implied that where women feel nervous talking about contraception, the successful application of mHealth tools can strengthen the interactivity of the health communication and could increase the likelihood of using contraception. However, while it may improve health communication that can inform health decisions, it may be insufficient on its own to cause behaviour change.

Keywords: contraceptive, e-health, psycho-social, women

Procedia PDF Downloads 102

Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

Abstract:

Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

Procedia PDF Downloads 115

Authors: Getahun Lemma

Abstract:

Introduction Guinea Worm Disease (GWD), also known as dracunculiasisis, is one of the oldest diseases in the history of mankind. Dracunculiasis is caused by a parasitic nematode, Dracunculus medinensis. Infection is acquired by drinking contaminated water with copepods containing infective Guinea Worm (GW) larvae). Almost one year after the infection, the worm usually emerges out through the skin on a lower, causing severe pain and disabilities. Although there is no effective drug or vaccine against the disease, the chain of transmission can be effectively prevented with simple and cost effective public health measures. Death due to dracunculiasis is very rare. However, it results in a wide range of physical, social and economic sequels. The disease is usually common in the rural, remote places of Sub-Saharan African countries among the marginalized societies. Currently, GWD is one of the neglected tropical diseases, which is on the verge of eradication. The global Guinea Worm Eradication Program (GWEP) was started in 1980. Since then, the program has achieved a tremendous success in reducing the global burden and number of GW case from 3.5 million to only 28 human cases at the end of 2018. However, it has recently been shown that not only humans can become infected, with a total of 1,105 animal infections have been reported at the end of 2018. Therefore, the objective of this study was to identify the existing challenges in the last mile of the GWEP in order To inform Policy makers and stakeholders on potential measures to finally achieve eradication. Method Systematic literature review on articles published from January 1, 2000 until May 30, 2019. Papers listed in Cochrane Library, Google Scholar, ProQuest PubMed and Web of Science databases were searched and reviewed. Results Twenty-five articles met inclusion criteria of the study and were selected for analysis. Hence, relevant data were extracted, grouped and descriptively analyzed. Results showed the main challenges complicating the last mile of global GWEP: 1. Unusual mode of transmission; 2. Rising animal Guinea Worm infection; 3. Suboptimal surveillance; 4. Insecurity; 5. Inaccessibility; 6. Inadequate safe water points; 7. Migration; 8. Poor case containment measures, 9. Ecological changes; and 10. New geographic foci of the disease. Conclusion This systematic review identified that most of the current challenges in the GWEP have been present since the start of the campaign. However, the recent change in epidemiological patterns and nature of GWD in the last remaining endemic countries illustrates a new twist in the global GWEP. Considering the complex nature of the current challenges, there seems to be a need for a more coordinated and multidisciplinary approach of GWD prevention and control measures in the last mile of the campaign. These new strategies would help to make history by eradicating dracunculiasis as the first ever parasitic disease.

Keywords: dracunculiasis, eradication program, guinea worm, last mile

Procedia PDF Downloads 110

Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

Abstract:

Background: Physical activity is an important factor in the treatment and prevention of type 2 diabetes mellitus (T2DM). Reduction in HbA1c level, an important diabetes biomarker, was reported in patients who increased their daily physical activity. Although the ambient temperature was reported to be positively correlated to a negative impact on health and increase the incidences of diabetes, the exposure to bright sunlight was recently found to be associated with enhanced insulin sensitivity and improved beta-cell function. How Ramadan alters physical activity, and especially sunlight exposure, has not been adequately investigated. Aim: This study aimed to assess the physical activity and sun exposure of Saudis with T2DM over different periods (before, during, and after Ramadan) and related this to HbA1c levels. Methods: This study recruited 82 Saudis with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for this study were obtained from De Montfort University and Saudi Ministry of Health. Physical activity and sun exposure were assessed by a self-administered questionnaire. Physical activity was estimated using the International Physical Activity Questionnaire (IPAQ), while the sun exposure was assessed by asking the patients about their hours per week of direct exposure to the sun, and daily hours spent outdoors. Blood samples were collected in each period for measuring HbA1c. Results: Low physical activity was observed in more than 60% of the patients, with no significant changes between periods. There were no significant variances between periods in the daily hours spent outdoors and the total number of weekly hours of direct exposure to the sun. The majority of patients reported only few hours of exposure to the sun (1h or less per week) and time spent outdoors (1h or less per day). The mean HbA1c significantly changed between periods (P = 0.001), with lowest level during Ramadan. There were significant differences in the mean HbA1c between the groups for the level of physical activity (P < 0.001), with significant lower mean HbA1c in the higher-level group. There were no significant variances in the mean of HbA1c between the groups for the daily hours spent outdoors. The mean HbA1c of the patients, who reported never in their total weekly hours of exposure to the sun, was significantly lower than the mean HbA1c of those who reported 1 hour or less (P = 0.001). Conclusion: Physical inactivity was prevalent among the study population with very little exposure to the sun or time spent outdoors. Higher level of physical activity was associated with lower mean HbA1c levels. Encouraging T2DM patients to achieve the recommended levels of physical activity may help them to obtain greater benefits of Ramadan fasting, such as reducing their HbA1c levels. The impact of low direct exposure to the sun and the time spent outdoors needs to be further investigated in both healthy and diabetic patients.

Keywords: diabetes, fasting, physical activity, sunlight, Ramadan

Procedia PDF Downloads 148

Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

Abstract:

A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team

Procedia PDF Downloads 136

Authors: Ananya Gangavarapu

Abstract:

Convolutional Neural Networks (CNN) based models are providing diagnostic capabilities on par with the medical specialists in many specialty areas. However, collecting the medical data for training purposes is very challenging because of the increased regulations around data collections and privacy concerns around personal health data. The gathering of the data becomes even more difficult if the capture devices are edge-based mobile devices (like smartphones) with feeble wireless connectivity in rural/remote areas. In this paper, I would like to highlight Federated Learning approach to mitigate data privacy and security issues.

Keywords: deep learning in healthcare, data privacy, federated learning, training in distributed environment

Procedia PDF Downloads 124

Authors: Trupti Chavan, Ramachandra Guda, Kameshwar Rao

Abstract:

The lack of data is a pain problem in medical image analysis using a convolutional neural network (CNN). This work uses various spatial transformation techniques to address the medical image augmentation issue for knee detection and localization using an enhanced single shot detector (SSD) network. The spatial transforms like a negative, histogram equalization, power law, sharpening, averaging, gaussian blurring, etc. help to generate more samples, serve as pre-processing methods, and highlight the features of interest. The experimentation is done on the OpenKnee dataset which is a collection of knee images from the openly available online sources. The CNN called enhanced single shot detector (SSD) is utilized for the detection and localization of the knee joint from a given X-ray image. It is an enhanced version of the famous SSD network and is modified in such a way that it will reduce the number of prediction boxes at the output side. It consists of a classification network (VGGNET) and an auxiliary detection network. The performance is measured in mean average precision (mAP), and 99.96% mAP is achieved using the proposed enhanced SSD with spatial transformations. It is also seen that the localization boundary is comparatively more refined and closer to the ground truth in spatial augmentation and gives better detection and localization of knee joints.

Keywords: data augmentation, enhanced SSD, knee detection and localization, medical image analysis, openKnee, Spatial transformations

Procedia PDF Downloads 137

Authors: Yingyi Luo

Abstract:

Cross-border commercial surrogacy, where Australians travel overseas to access reproduction through a surrogate mother, is an increasing phenomenon. This paper focuses on the role of Australian surrogacy facilitators, including lawyers, non-for-profit agents, fertility counselors, who act as intermediaries managing cross-border surrogacy arrangements in Australia. It explores the extent to which surrogacy facilitators are concerned with the human rights of children born through cross-border surrogacy, surrogate mothers in developing countries, and intended parents. Commercial surrogacy is a matter that is often cast in the language of human rights. This paper will contribute to an in-depth understanding of the dynamics between intended parents, surrogates, and surrogacy facilitators by adopting a human rights framework to inform data analysis regarding the role of facilitators. The purpose of this research is to inform debate and discussion on law reform related to surrogacy. This paper presented here centers on interviews with surrogacy facilitators in Australia and non-participant observations in Australia to generate thick, empirical data about the fertility industry. The data showed that the process of facilitating surrogacy arrangements had prompted facilitators to form a view on human rights as they applied to their works. Although facilitators claimed that the right of intended parents, surrogate mothers, and children were all taken into consideration, the researcher observed that the commercial surrogacy contracts described by these facilitators favored the interests of intended parents with the baby acting as their unique selling point. The interests and needs of surrogate mothers were not prioritized in the views or actions of facilitators. The result was a commercial transaction that entailed the purchase, through cross-border surrogacy, of a child, as a commodity, by relatively affluent intended parents from disadvantaged surrogate mothers through unfair contracts.

Keywords: cross-border surrogacy, facilitators, human rights, surrogacy

Procedia PDF Downloads 98

Authors: Lourenço Bastos, Filipa Carneiro, Bruno Vale, Rita Marques Joana Silva, Ricardo Freitas, Ângelo Marques, Sara Cortez, Alberta Coelho, Pedro Parreira, Liliana Sousa, Anabela Salgueiro, Bruno Silva

Abstract:

The process of flushing is considered to be an adequate technique to reduce the risk of infection during the clinical practice of venous catheterization. Nonetheless, there is still a lack of adhesion to this method, in part due to the complexity of this procedure. The project SeringaDuo aimed to develop an innovative double-chamber syringe for intravenous sequential administration of drugs and serums. This device served the purpose of improving the adherence to the practice, through the reduction of manipulations needed, which also improves patient safety, and though the promotion of flushing practice by health professionals, by simplifying this task. To assist on the development of this innovative syringe, a numerical methodology was developed and validated in order to predict the syringe’s mechanical and flow behavior during the fluids’ loading and administration phases, as well as to allow the material behavior evaluation during its production. For this, three commercial numerical simulation software was used, namely ABAQUS, ANSYS/FLUENT, and MOLDFLOW. This methodology aimed to evaluate the concepts feasibility and to optimize the geometries of the syringe’s components, creating this way an iterative process for product development based on numerical simulations, validated by the production of prototypes. Through this methodology, it was possible to achieve a final design that fulfils all the characteristics and specifications defined. This iterative process based on numerical simulations is a powerful tool for product development that allows obtaining fast and accurate results without the strict need for prototypes. An iterative process can be implemented, consisting of consecutive constructions and evaluations of new concepts, to obtain an optimized solution, which fulfils all the predefined specifications and requirements.

Keywords: Venous catheterization, flushing, syringe, numerical simulation

Procedia PDF Downloads 147

Authors: Joleen L. H. Lee, K. F. Yen, Janette W. P. Ng, D. Woon, Mandy M. Y. Lau, Ivan M. H. Woo, S. N. Goh

Abstract:

Case assignment systems are created to meet a need for equity in work distribution and better match between medical social workers' (MSWs) competencies and patients' problems. However, there is no known study that has explored how MSWs in Singapore assign cases to achieve equity in work distribution. Focus group discussions were conducted with MSWs from public hospitals to understand their perception on equitable workload and case allocation. Three approaches to case allocation were found. First is the point system where points are allocated to cases based on a checklist of presenting issues identified most of the time by non-MSWs. Intensity of case is taken into consideration, but allocation of points is often subject to variation in appreciation of roles of MSWs by the source of referral. Second is the round robin system, where all MSWs are allocated cases based on a roster. This approach resulted in perceived equity due to element of luck, but it does not match case complexity with competencies of MSWs. Third approach is unit-based allocation, where MSWs are assigned to attend to cases from specific unit. This approach helps facilitate specialization among MSWs but may result in MSWs having difficulty providing transdisciplinary care due to narrow set of knowledge and skills. Trade-offs resulted across existing approaches for case allocation by MSWs. Conversations are needed among Singapore MSWs to decide on a case allocation system that comes with trade-offs that are acceptable for patients and other key stakeholders of the care delivery system.

Keywords: case allocation, equity, medical social worker, work distribution

Procedia PDF Downloads 109

Authors: Sandeep Reddy, Sonia Allan, Simon Coghlan, Paul Cooper

Abstract:

Artificial Intelligence (AI) and its application in medicine has generated ample interest amongst policymakers and clinicians. Successes with AI in medical imaging interpretation and clinical decision support are paving the way for its incorporation into routine healthcare delivery. While there has been a focus on the development of ethical principles to guide its application in healthcare, challenges of this application go beyond what ethics principles can address thus requiring robust governance frameworks. Also, while ethical challenges of medical artificial intelligence are being discussed, the ethics of deploying AI in lower-income countries receive less attention than in other developed economies. This creates an imperative not only for sound ethical guidelines but also for robust governance frameworks to regulate AI in medicine around the world. In this article, we discuss what components need to be considered in developing these governance frameworks and who should lead this worldwide effort.

Keywords: artificial intelligence, global health, governance, ethics

Procedia PDF Downloads 132

Authors: Sahar Elsaleh, Ghada Farhat, Shaikha Al-Derham, Fasih Alam

Abstract:

Background: Cesarean section (CS) delivery is one of the major concerns both in developing and developed countries. The rate of CS deliveries are on the rise globally, and especially in Qatar. Many socio-economic, demographic, clinical and institutional factors play an important role for cesarean sections. This study aims to investigate factors affecting the prevalence of CS among women in Qatar using the UNICEF’s Multiple Indicator Cluster Survey (MICS) 2012 database. Methods: The study has focused on the women’s questionnaire of the MICS, which was successfully distributed to 5699 participants. Following study inclusion and exclusion criteria, a final sample of 761 women aged 19- 49 years who had at least one delivery of giving birth in their lifetime before the survey were included. A number of socio-economic, demographic, clinical and institutional factors, identified through literature review and available in the data, were considered for the analyses. Bivariate and multivariate logistic regression models, along with a multi-level modeling to investigate clustering effect, were undertaken to identify the factors that affect CS prevalence in Qatar. Results: From the bivariate analyses the study has shown that, a number of categorical factors are statistically significantly associated with the dependent variable (CS). When identifying the factors from a multivariate logistic regression, the study found that only three categorical factors -‘age of women’, ‘place at delivery’ and ‘baby weight’ appeared to be significantly affecting the CS among women in Qatar. Although the MICS dataset is based on a cluster survey, an exploratory multi-level analysis did not show any clustering effect, i.e. no significant variation in results at higher level (households), suggesting that all analyses at lower level (individual respondent) are valid without any significant bias in results. Conclusion: The study found a statistically significant association between the dependent variable (CS delivery) and age of women, frequency of TV watching, assistance at birth and place of birth. These results need to be interpreted cautiously; however, it can be used as evidence-base for further research on cesarean section delivery in Qatar.

Keywords: cesarean section, factors, multiple indicator cluster survey, MICS database, Qatar

Procedia PDF Downloads 100

Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

Abstract:

Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

Procedia PDF Downloads 106